Aortic valve stenosis is a narrowing of the aortic valve opening between the left ventricle and aorta. It is most commonly caused by age-related calcification of the normal three-leafed valve. As the opening narrows, the left ventricle must work harder to pump blood through, causing thickening of its walls. In later stages, the ventricle dilates and pumping function deteriorates. Symptoms range from shortness of breath to chest pain and syncope. While medical therapy has limited effect, severe symptomatic stenosis requires surgery to replace the valve.

1. AORTIC VALVE STENOSIS
Mónica Delgado

2.  Aortic valve stenosis is a disease of the
heart valves in which the opening of the
aortic valve is narrowed. The aortic valve is
the valve between the left ventricle of the
heart and the aorta.

4.  Aortic stenosis is most commonly caused by age-
related progressive calcification of a normal (three-
leafed) aortic valve (>50% of cases) mean age 65
to 70 years old - most common cause.
 Other causes include calcification of a congenital
bicuspid aortic valve most common cause and
acute rheumatic fever post-inflammatory.

5.  When the opening of the aortic valve becomes
narrowed or constricted ( stenotic ), the blood can't
be pumped adequately and the pressure in the left
ventricle increases. Initially, the LV compensates
by thickening its walls (myocardial hypertrophy) in
order to maintain adequate pumping pressure. In
the later stages, the left ventricle dilates, the wall
thins, and the systolic function deteriorates.

6.  Symptoms related to aortic stenosis depend on the
degree of valve stenosis.
 Symptoms usually are manifest in those with
severe aortic stenosis. The initial presenting
symptoms include progressive shortness of breath
on exertion , which may be so subtle that the
patient is unaware of them.
 More worrisome symptoms include syncope, chest
pain and sudden death.

7.  Aortic stenosis is most often diagnosed when it is
asymptomatic and can sometimes be detected
during routine examination of the heart and
circulatory system. There may also be a noticeable
delay between the first heart sound (on auscultation
) and the corresponding pulse in the carotid artery
(so-called 'apical-carotid delay').

8. MEDICAL
 In general, any medical therapy has relatively poor
effect in treating aortic stenosis.
 Since calcific aortic stenosis shares many
pathological features and risk factors with
atherosclerosis , and since atherosclerosis may be
prevented and/or reversed by cholesterol lowering,
there has been interest in attempting to modify the
course of calcific aortic stenosis by cholesterol
lowering with statin drugs. Although a number of
small, observational studies demonstrated an
association between lowered cholesterol and
decreased progression, and even regression, of
calcific aortic stenosis.

9. ISSUE IN ECUADOR
 Approximately 2% of people over the age of 65, 3%
of people over age 75, and 4% percent of people
over age 85 have aortic valve stenosis.The
prevalence is increasing with the aging population.

10.  In the new born, abnormalities of the left ventricle,
the aortic valve or other heart and aortic
abnomalities may lead the Ductus Ateriosus
remaining open, or the Duct may remain open with
no other abnormality.
 There is no medical treatment for aortic stenosis.
Symptoms need assessment for surgery, severe
symptoms may need urgent surgery.

11.  In Heyde's syndrome , aortic stenosis is associated
with angiodysplasia of the colon . The stenosis
causes a form of von Willebrand disease by
breaking down its associated coagulation factor (
factor VIII -associated antigen, also called von
Willebrand factor ), due to increased turbulence
around the stenosed valve.